October 31, 2019 | Obamacare prices dropping
October 31, 2019
INDUSTRY NEWS
Prices for the silver plans offered through the ACA’s federal marketplace will drop next year, and the number of insurers offering plans will increase. The 4% price decline is only the second time that average monthly premiums have dropped year-to-year since the marketplace opened in 2014. It’s a sign the ACA is stabilizing after several years of turmoil, the New York Times reports. For a 27-year-old, premiums for a benchmark silver plan will average $388 per month; for a family of four, they will average $1,520 per month. Open enrollment starts Nov. 1. (New York Times)
Primary Care First model delayed by a year
The new value-based payment model to transform primary care—Primary Care First—has been delayed until 2021. CMS had initially planned to launch the first five-year PCF cohort in January 2020. The Center for Medicare & Medicaid Innovation, which manages the agency’s experimental payment models, didn’t cite a reason for the delay, HealthLeaders Media reports. The delay wasn’t officially announced; it was revealed in a detailed document on the application process. (HealthLeaders Media)
INNOVATION & TRANSFORMATION
PCPCC conference: Evaluate. Collaborate. Advocate.
This year’s Patient-Centered Primary Care Collaborative conference begins Monday at noon; its theme: Evaluate. Collaborate. Advocate. It will provide a forum for participants to evaluate exemplar advanced primary care practices with proven results; collaborate face-to-face with leaders across diverse sectors who are advancing strategies to strengthen primary care; and join with colleagues advocating for payment and delivery reforms, including more investment in primary care. The PCPCC Tech Pre-conference, Digital Disruption: Activating Primary Care, will focus on innovations that better integrate, coordinate and customize care and strengthen critical relationships. It begins at 8:30 Monday. (Conference details)
Publix, Flagler launch pharmacy-based telehealth program
Flagler Health+ plans to open at least five telehealth clinics in Publix pharmacies in St. Johns County, Fla. It launched the first kiosk this month. In addition to the screen, the kiosk features medical equipment, including a stethoscope, a blood pressure cuff, a pulse oximeter and a thermometer. Pharmacists are available to help. It’s staffed remotely by local Flagler Health+ physicians in the area or by American Well physicians. The co-pay is $59. (Jacksonville Daily Record)
CONSUMERS & PROVIDERS
The ghost in the machine: racial bias
An Optum algorithm widely used in hospitals to prioritize patients according to health care spending has a built-in bias. Hospitals use the algorithm to identify patients with chronic conditions who could benefit from care coordination. But the algorithm gave healthier white patients the same ranking as black patients who had one more chronic illness as well as poorer laboratory results and vital signs. The study, published in Science, concluded that the algorithm was less likely to refer black people than white people who were equally sick to programs designed for patients with complex medical needs. (The Wall Street Journal; Science)
Scary correlation: Income changes linked to CVD risk
Individuals’ changing finances were tied to subsequent long-term risk of cardiovascular disease, according to large prospective cohort study published in JAMA Cardiology. Study participants whose household income dropped by more than 50% over a six-year period during the 1980s and 1990s had significantly higher risk of CVD over the next 17 years compared with people with more stable incomes. On the flip side, income that grew 50% or more over that initial period was associated with lower CVD risk during follow-up. (MedPageToday; JAMA Cardiology)
NEW & NOTED
Amazon’s next health care buy: Amazon has acquired Health Navigator, which will join the Amazon Care group. Amazon Care is designed to serve as a medical benefit for employees and helps provide care virtually, through a video visit and, if needed, home visits. Health Navigator provides online symptom checking and triage tools. (CNBC)
Pay up: The federal government must pay health insurance plans $1.6 billion in unpaid subsidies, a federal judge ruled. The insurers are part of a class action brought by Wisconsin-based Common Ground Healthcare Cooperative, which challenged the federal government’s failure to pay cost-sharing reduction subsidies. An appeal is expected. (Modern Healthcare)
Any day now: A federal appeals court in New Orleans is preparing a long-awaited ruling on the Affordable Care Act. At issue: whether to uphold a lower court ruling that the law’s requirement for most Americans to have health insurance is unconstitutional, and that the rest of the law cannot function without it. (New York Times)
MULTI-MEDIA
Opioid epidemic costs: Hospitals suing pharma
Some hospitals, having provided billions in charity care for addiction, are suing drug makers. They consider the state-based suits as their best hope for winning meaningful settlement money. (NPR)
MARKETVOICES...QUOTES WORTH READING
“It’s a tool that can do a great deal of good and a great deal of bad, it merely depends on how we use the tool.”—Sendhil Mullainathan, a University of Chicago computational science professor who was an author of a study that found bias inherent in a common algorithm used in hospitals, quote in The Wall Street Journal